The Structural Pre-Requisites for Clinical Leadership

Following a critical review of the conceptual foundations of current calls for leadership, this paper assesses the extent to which the preconditions for clinical leadership are evident in healthcare settings. In detail, it examines how prevailing professional cultures may be affecting the followership of clinical leaders. It then assess the extent to which existing health policies, structures and methods are aligned to structurally underpin the authority that leaders are meant to exercise

Sociocultural dimensions of tuberculosis: an overview of key concepts

Biomedical innovations are unlikely to provide effective and ethical tuberculosis (TB) control measures without complementary social science research. However, a strong interest in interdisciplinary work is often undermined by differences in language and concepts specific to each disciplinary approach. Accordingly, biological and social scientists need to learn how to communicate with each other. This article will outline key concepts relating to TB from medical anthropology and health sociology. Distilling these concepts in an introductory framework is intended to make this material accessible to researchers in laboratory, clinical and fieldwork settings, as well as to encourage more social scientists to engage with TB research among target groups critical for successful programmatic interventions. For pedagogical purposes, the relevant concepts are grouped into three categories: 1) structures and settings, which includes overarching themes such as syndemics, local biologies, medicalisation, structural violence and surveillance; 2) practices and processes, encompassing gender, stigma, taboo, and victim blaming; and 3) experience and enculturation, which includes illness narratives, biographical disruption and dynamic nominalism. By helping to navigate this literature, we hope to foster more cross-disciplinary conversations between qualitative and quantitative researchers. TB, a quintessential social disease, will be controlled more effectively using a multistranded research approach

Ergonomics in control room design

Ergonomic contributions in early design phases of large-scale projects are not yet common practice. In this paper a description is given of a control room design project, in which ergonomists participated from the very beginning. First, the scope of the project and a methodical approach to the design are introduced. This is followed by an overview of the activities of ergonomists in this particular project. The second part of this paper concerns the experiences with this methodical approach and design practice. These are discussed by the former control room project manager, one of the ergonomists, the interior architect and a user representative. It is concluded that it is possible to include ergonomics as well as user participation in every design phase without getting behind on time schedules and keeping within available budgets. A lot of useful design and engineering data could be derived from the situation analysis in the existing situation and the full-scale mock-up evaluation that was carried out. Besides workplace design, job design (operator workload) and work organization design were essential to the success of the project

Eliminating latent tuberculosis in low-burden settings: are the principal beneficiaries to be disadvantaged groups or the broader population?

Tuberculosis (TB) remains a leading cause of morbidity and mortality worldwide, and the burdens of this disease continue to track prior disadvantage. In order to galvanise a coordinated global response, WHO has recently launched the End TB Campaign that aims to eliminate TB by 2050. Key to this is the introduction of population screening programmes in low-burden settings to identify and treat people who have latent TB infection (LTBI). The defining features of LTBI are: that it is not an active disease but confers an increased risk of disease; the socially disadvantaged are those most in danger and uncertainty persists as to who will be harmed or benefitted from screening-led prophylactic interventions. Systematic screening programmes that include surveillance, case-finding and treatment of asymptomatic individuals inevitably redistribute the risk of harms and the potential for benefits within a population. The extent to which those targeted within such programmes should be exposed to higher levels of risk in the pursuit of individual or community benefits requires careful consideration prior to implementation. As currently construed, it remains unclear who stands to benefit most from how LTBI screening in high-income countries is being organised, and whose health is being prioritised: members of disadvantaged groups or the broader community. Unless the aims of LTBI screening programmes in these settings are made transparent and their prioritisation ethically justified, there is a significant danger that such a targeted intervention will further disadvantage those who have the least capacity to bear the burdens of TB elimination.NHMRC Centre for Research Excellence in TB Control (CRE 1043225)

A magmatic copper and fluid source for the sediment-hosted Mount Isa deposit

The world class Mount Isa deposit is a unique, sediment-hosted, copper deposit with no known equivalent around the world and a controversial origin. We report δ65Cu values (n = 90) from chalcopyrite grains collected systematically across the entire deposit. The δ65Cu shows a unimodal distribution with limited variability (min = −0.87 ‰; max = 0.88 ‰) and an average value (+0.13 ‰) comparable to average igneous rocks. In general, the δ65Cu values in chalcopyrite are lower near major structures and heavier further away, consistent with equilibrium fractionation with distance from the fluid source. The range in δ65Cu of chalcopyrite from the Mount Isa deposit is less variable compared to sedimentary copper, VMS and porphyry/epithermal deposits, but similar to Michigan deposits; meanwhile, average δ65Cu at Mt. Isa is distinctly higher than sedimentary copper deposits, but similar to VMS, porphyry/epithermal and Michigan deposits. These data suggest that, from a copper isotope perspective, the Mount Isa deposit is clearly different from sedimentary copper deposits and more like VMS, porphyry copper/epithermal and Michigan style deposits. The average δ65Cu (+0.13 ‰) is almost identical to the average δ65Cu (+0.14 ‰) from Proterozoic basalts and suggests that copper was sourced from the underlying mafic rocks; the limited fractionation and the normal distribution of the δ65Cu indicate a very effective leaching mechanism and transport by a hot fluid from which chalcopyrite precipitated without significant fractionation of copper isotopes

CJCheck Stage 1: development and testing of a checklist for reporting community juries – Delphi process and analysis of studies published in 1996–2015

Background Opportunities for community members to actively participate in policy development are increasing. Community/citizen's juries (CJs) are a deliberative democratic process aimed to illicit informed community perspectives on difficult topics. But how comprehensive these processes are reported in peer-reviewed literature is unknown. Adequate reporting of methodology enables others to judge process quality, compare outcomes, facilitate critical reflection and potentially repeat a process. We aimed to identify important elements for reporting CJs, to develop an initial checklist and to review published health and health policy CJs to examine reporting standards. Design Using the literature and expertise from CJ researchers and policy advisors, a list of important CJ reporting items was suggested and further refined. We then reviewed published CJs within the health literature and used the checklist to assess the comprehensiveness of reporting. Results CJCheck was developed and examined reporting of CJ planning, juror information, procedures and scheduling. We screened 1711 studies and extracted data from 38. No studies fully reported the checklist items. The item most consistently reported was juror numbers (92%, 35/38), while least reported was the availability of expert presentations (5%, 2/38). Recruitment strategies were described in 66% of studies (25/38); however, the frequency and timing of deliberations was inadequately described (29%, 11/38). Conclusions Currently CJ publications in health and health policy literature are inadequately reported, hampering their use in policy making. We propose broadening the CJCheck by creating a reporting standards template in collaboration with international CJ researchers, policy advisors and consumer representatives to ensure standardized, systematic and transparent reporting.RT was supported by a NHMRC Screening and Test Evaluation Program (STEP) Grant (#633033). RS was supported by a Bond University Vice Chancellor’s Research Grant Scheme. CD, SMC and LR received funding support from NHMRC Project Grant (#1023197). CD received funding support from a NHMRC Project Grant (#1083079). SMC is funded through NHMRC Career Development Fellowship (#1032963). JMS was funded by an Australian National Preventive Health Agency Fellowship (20STR2013F) and an NHMRC Capacity Building Grant (565501)

'Like building a plane and flying it all in one go': an interview study of infection prevention and control in Australian general practice during the first 2 years of the SARS-CoV-2 pandemic.

OBJECTIVES: General practitioners (GPs) and their staff have been at the frontline of the SARS-CoV-2 pandemic in Australia. However, their experiences of responding to and managing the risks of viral transmission within their facilities are poorly described. The aim of this study was to describe the experiences, and infection prevention and control (IPC) strategies adopted by general practices, including enablers of and challenges to implementation, to contribute to our understanding of the pandemic response in this critical sector. DESIGN: Semistructured interviews were conducted in person, by telephone or online video conferencing software, between November 2020 and August 2021. PARTICIPANTS: Twenty general practice personnel working in New South Wales, Australia, including nine GPs, one general practice registrar, four registered nurses, one nurse practitioner, two practice managers and two receptionists. RESULTS: Participants described implementing wide-ranging repertoires of IPC strategies-including telehealth, screening of patients and staff, altered clinic layouts and portable outdoor shelters, in addition to appropriate use of personal protective equipment (PPE)-to manage the demands of the SARS-CoV-2 pandemic. Strategies were proactive, influenced by the varied contexts of different practices and the needs and preferences of individual GPs as well as responsive to local, state and national requirements, which changed frequently as the pandemic evolved. CONCLUSIONS: Using the 'hierarchy of controls' as a framework for analysis, we found that the different strategies adopted in general practice often functioned in concert with one another. Most strategies, particularly administrative and PPE controls, were subjected to human variability and so were less reliable from a human factors perspective. However, our findings highlight the creativity, resilience and resourcefulness of general practice staff in developing, implementing and adapting their IPC strategies amidst constantly changing pandemic conditions

Entanglements of affect, space, and evidence in pandemic healthcare: An analysis of Australian healthcare workers' experiences of COVID-19.

The COVID-19 pandemic continues to highlight both global interconnectedness and schisms across place, context and peoples. While countries such as Australia have securitised their borders in response to the global spread of disease, flows of information and collective affect continue to permeate these boundaries. Drawing on interviews with Australian healthcare workers, we examine how their experiences of the pandemic are shaped by affect and evidence 'traveling' across time and space. Our analysis points to the limitations of global health crisis responses that focus solely on material risk and spatial separation. Institutional responses must, we suggest, also consider the affective and discursive dimensions of health-related risk environments

Van Allen probes observations of a three-dimensional field line resonance at a plasmaspheric plume

Funding: JKS, KRM, and IJR acknowledge support from NERC Grants NE/P017185/2, NE/V002554/2, and STFC Grants ST/V006320/1, ST/X001008/1. DPH acknowledges NASA Grant 80NSSC20K1324. ANW was funded in part by STFC Grant ST/W001195/1. AWS was supported by NERC Independent Research Fellowship NE/W009129/1.Field Line Resonances (FLRs) are a critical component in Earth's magnetospheric dynamics, associated with the transfer of energy between Ultra Low Frequency waves and local plasma populations. In this study we investigate how the polarisation of FLRs are impacted by cold plasma density distributions during geomagnetic storms. We present an analysis of Van Allen Probe A observations, where the spacecraft traversed a storm time plasmaspheric plume. We show that the polarisation of the FLR is significantly altered at the sharp azimuthal density gradient of the plume boundary, where the polarisation is intermediate with significant poloidal and toroidal components. These signatures are consistent with magnetohydrodynamic modeling results, providing the first observational evidence of a 3D FLR associated with a plume in Earth's magnetosphere. These results demonstrate the importance of cold plasma in controlling wave dynamics in the magnetosphere, and have important implications for wave-particle interactions at a range of energies.Publisher PDFPeer reviewe